Perils of a sunny lifestyle

A sunnier world encourages young people to expose more skin. This increases the risk of malignant melanoma skin cancer. The American Society of Clinical Oncology recently reported on two studies using new drugs to prolong the life of those with advanced melanomas.

As the world slowly warms up, bringing with it longer hours of sunshine, concerns have been raised about the worldwide increase in the number of cases of skin cancer.

There are two types of skin cancer; malignant melanoma, which is less common but more serious and non-malignant melanoma, which is very common but not so serious.

Melanoma skin cancer is now the sixth most common cancer in the UK and rates have quadrupled over the last thirty years. In other countries like Australia where there is more sunshine it can be much more common.

Like most cancers skin cancer is more common with increasing age, but certainly in the UK there is a worrying trend for younger people to be affected. Almost a third of the cases of malignant melanoma in the UK now occur in people under 55. Young adults in the 15 to 34 age group are particularly vulnerable and every day more than two are diagnosed with malignant melanoma, making it the second most common form of cancer in this age group. Thirty years ago it was the seventh.

For men the most common sites for melanoma are on the chest or back, while for women the most common site is on the legs.

As with all cancers, early diagnosis significantly improves the chances of survival and in spite of the rise in the number of cases, survival rates have been improving for the last 25 years, but in the UK about 2,000 people die of malignant melanoma skin cancer each year.

If a malignant melanoma goes untreated, the cancer can rapidly spread to other parts of the body, by which time it is practically untreatable. Fewer than 10% of cases respond to traditional chemotherapy.

At a recent meeting of the American Society of Clinical Oncology scientists reported promising results with two new kinds of drugs. Although they are not able to provide a cure, there is evidence that these new drugs are able to prolong life.

The first study used ipilimumab, which is a drug that helps the immune system fight cancer. The study showed that 21% of patients who had been treated with this, in additional to conventional chemotherapy, were still alive three years later, compared with only 12% of those who had just received chemotherapy.

In the second study an experimental drug called vermurafenib was used. This drug targets a specific gene mutation that triggers growth in about half of all advanced melanomas. Patients with advanced melanoma who were given this drug in addition to chemotherapy were 63% less likely to die within three months than those receiving chemotherapy alone.

The next stage is to match the specific mutations to the appropriate drugs, or combinations of drugs.

The only real solution is to reduce the risk of skin cancer in the first place. As the world warms up and the sunny days get longer there will be a greater incentive, especially among young people to expose more skin. They must learn that this can prove to be fatal.

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